Kalle Kurppa's research while affiliated with Tampere University and other places
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Publications (216)
Data on alanine aminotransferase (ALT) measurement practices and diagnoses associated with increased values are limited. We evaluated these issues by collecting ALT measurements from 1‐ to 16‐year‐old patients investigated in 1992–2018 in a tertiary center. Diagnoses were gathered in 2008–2018. Altogether 145,092 measurements from 28,118 children w...
Introduction
Due to a steep increase in obesity, metabolic dysfunction‐associated fatty liver disease (MAFLD) has also become the most common chronic hepatic condition among children and adolescents. Various maternal and pregnancy‐related factors have also been implicated in the development of MAFLD, but human studies remain scarce.
Material and m...
Purpose
The aim was to study the association between dietary intake of B vitamins in childhood and the risk of islet autoimmunity (IA) and progression to type 1 diabetes (T1D) by the age of 10 years.
Methods
We followed 8500 T1D-susceptible children born in the U.S., Finland, Sweden, and Germany in 2004 -2010 from the Environmental Determinants of...
Histological evaluation of small bowel biopsies remains the gold standard diagnostic and follow-up outcome in celiac disease. X-ray microtomography (µCT) has been introduced as a complementary imaging tool to assess histological changes from the mucosal biopsies, however, this has thus far not been allowing further histological processing. It has b...
Objectives:
It has been suggested that celiac disease could be diagnosed non-invasively in adults with transglutaminase antibody (TGA) levels >10x upper limit of normal (ULN). It is, however, unclear if high values signify more advanced disease and higher risk of co-morbidities. We investigated the association between the TGA levels, clinical char...
Objectives and Study
The often‐recommended alanine aminotransferase (ALT) cutoffs (girls 21 U/l, boys 25 U/l) are based on a NHANES cohort. A novel concept of metabolic dysfunction associated steatotic liver disease (MASLD) emphasizes the role of ALT. We tested the prevalence of increased ALT and MASLD in children with overweight or obesity applyin...
Background
The prevalence of coeliac disease doubled in Finland from 1980 to 2000.
Aims
To investigate whether this increase is continuing and if there are specific patient‐related factors predicting the development of coeliac disease at a population level.
Methods
We elicited comprehensive health data in the nationwide Health 2000 and Health 201...
Background
Higher gluten intake in childhood is associated with increased incidence of celiac disease autoimmunity (CDA) and celiac disease. It remains to be studied whether different dietary patterns independent of gluten intake contribute to the incidence.
Objectives
This study aimed to explore associations of dietary patterns by age 2 y with ri...
Background
Vomiting and nausea seem to be relatively specific symptoms related to gluten ingestion in treated celiac disease. However, the overall prevalence and associated factors of these symptoms after chronic gluten exposure at celiac disease diagnosis and acute re-exposure during gluten challenge remain obscure.
Methods
Medical data on 815 ad...
OBJECTIVE
To investigate gastrointestinal infection episodes (GIEs) in relation to the appearance of islet autoantibodies in The Environmental Determinants of Diabetes in the Young (TEDDY) cohort.
RESEARCH DESIGN AND METHODS
GIEs on risk of autoantibodies against either insulin (IAA) or GAD (GADA) as the first-appearing autoantibody were assessed...
Introduction
Data on the prevalence of pediatric fatty liver disease remain limited, partly due to challenges in diagnosis. A novel concept of metabolic-associated fatty liver disease (MAFLD) makes it possible to establish the diagnosis in overweight children with sufficiently elevated alanine aminotransferase (ALT). We investigated the prevalence,...
Introduction:
Duodenal biopsy is the gold standard in the diagnosis of celiac disease, with increasing utilization of serology. A gluten challenge may be required, for example, when dietary gluten reduction precedes appropriate diagnostic evaluations. Evidence on the best challenge protocol is currently sparse. Pharmaceutical trials in recent year...
Background:
Celiac disease has an increasing incidence worldwide and is treated with lifelong adherence to a gluten-free diet. We aimed to describe gluten-free diet adherence rates in children with screening-identified celiac disease, determine adherence-related factors, and compare adherence to food records in a multinational prospective birth co...
Background:
Participants' study satisfaction is important for both compliance with study protocols and retention, but research on parent study satisfaction is rare. This study sought to identify factors associated with parent study satisfaction in The Environmental Determinants of Diabetes in the Young (TEDDY) study, a longitudinal, multinational...
Background
Celiac disease (CeD) is often accompanied by other autoimmune diseases (AID). However, the association of co-existing autoimmunity with the presentation and treatment success in CeD is unclear. We investigated these issues with a large and well-defined cohort of Finnish patients.
Methods
Adult CeD patients ( n = 806) were collected from...
Background
Duodenal histology remains the diagnostic reference standard in celiac disease. However, traditional methods have suboptimal sensitivity and reproducibility for early mucosal changes and research purposes. We validated a recently introduced micro-CT imaging method for an accurate digital evaluation of duodenal histomorphometry and mucosa...
OBJECTIVE
To distinguish among predictors of seroconversion, progression to multiple autoantibodies and from multiple autoantibodies to type 1 diabetes in young children.
RESEARCH DESIGN AND METHODS
Genetically high-risk newborns (n = 8,502) were followed for a median of 11.2 years (interquartile range 9.3–12.6); 835 (9.8%) developed islet autoant...
OBJECTIVE
Biomarkers predicting risk of type 1 diabetes (stage 3) among children with islet autoantibodies are greatly needed to prevent diabetic ketoacidosis and facilitate prevention therapies.
RESEARCH DESIGN AND METHODS
Children in the prospective The Environmental Determinants of Diabetes in the Young (TEDDY) study (n = 707) with confirmed di...
Objectives and study
Gastrointestinal endoscopy is often performed when investigating abdominal complaints in children. While atrophic changes of the duodenal mucosa are usually caused by celiac disease, the prevalence and clinical significance of non-atrophic duodenal changes are less clear. We studied these issues in a large pediatric endoscopic...
Background:
Low ferritin without anaemia has been linked to adverse health effects.
Objectives:
To investigate the prevalence and clinical significance of low ferritin in screen-detected coeliac disease.
Methods:
Seventy-six screen-detected coeliac disease patients were enrolled in the prospective collection of comprehensive clinical, laborato...
Background
The best‐known symptoms of coeliac disease are related to the gastrointestinal tract, but the disease may also present with various systemic manifestations outside the intestine. Some of these consequences may remain permanent in undiagnosed individuals or if the diagnostic delay is prolonged. However, for many of the systemic manifestat...
Objective
To investigate the prevalence and associated factors of persistent symptoms despite a strict gluten-free diet in adult patients with coeliac disease diagnosed in childhood.
Design
Medical data on 239 currently adult patients with paediatric diagnosis were collected from patient records. Also, patients completed structured study questionn...
Aim:
To gather the current evidence and to offer recommendations for follow-up and management.
Methods:
The Special Interest Group on Coeliac Diseases of the European Society of Paediatric Gastroenterology Hepatology and Nutrition formulated ten questions considered to be essential for follow-up care. A literature search (January 2010 - March 20...
Purpose
We evaluated adherence to a gluten-free diet and associated factors in adult celiac disease patients diagnosed in childhood.
Methods
Comprehensive medical data on 955 pediatric celiac disease patients was collected and study questionnaires sent to 559 who were now adults. All variables were compared between strictly adherent and non-adhere...
Background:
Serological screening of the relatives of coeliac disease patients is widely endorsed. However, the need for and the optimal timing of possible re-testing of once seronegative at-risk individuals for coeliac disease remain unclear.
Objective:
We investigated this issue by inviting a large cohort of previously screening-negative relat...
Background
High gluten intake is associated with increased risk of celiac disease (CD) in children at genetic risk.
Objectives
To investigate if different dietary gluten sources up to age two years confer different risks of celiac disease autoimmunity (CDA) and CD in children at genetic risk.
Design
Three-day food records were collected at age si...
Objective:
Assessment of the upper gastrointestinal tract (UGI) may enable more personalized treatment strategies in pediatric inflammatory bowel disease (IBD). However, data on the frequency and significance of these findings remain limited.
Methods:
Data on 132 pediatric IBD patients with systematic UGI sampling were collected and the baseline...
The Environmental Determinants of Diabetes in the Young (TEDDY) study enrolled 8676 children, 3–4 months of age, born with HLA-susceptibility genotypes for islet autoimmunity (IA) and type 1 diabetes (T1D). Whole-genome sequencing (WGS) was performed in 1119 children in a nested case–control study design. Telomere length was estimated from WGS data...
Objectives:
The clinical significance of Helicobacter pylori negative chronic gastritis (HPNCG) in children is unclear. We examined this issue in patients who had undergone esophagogastroduodenoscopy with systematic gastric sampling.
Methods:
Data of 1,178 consecutive children who underwent diagnostic esophagogastroduodenoscopy were collected. B...
Objective:
The Environmental Determinants of Diabetes in the Young (TEDDY) study is uniquely capable of investigating age-specific differences associated with type 1 diabetes. Because age is a primary driver of heterogeneity in type 1 diabetes, we sought to characterize by age metabolic derangements prior to diagnosis and clinical features associa...
Significant progress has been made in elucidating genetic risk factors influencing Type 1 diabetes (T1D); however, features other than genetic variants that initiate and/or accelerate islet autoimmunity that lead to the development of clinical T1D remain largely unknown. We hypothesized that genetic and environmental risk factors can both contribut...
Background
Undelayed diagnosis is thought to be a major determinant for good prognosis in pediatric inflammatory bowel disease (PIBD). However, factors predicting diagnostic delay and the consequences of this remain poorly defined. We investigated these issues in a well-defined cohort of PIBD patients.
Methods
Comprehensive electronic data were co...
Purpose and objectives
Given their role in homing immune cells to the intestine, CC motif chemokine receptor 9 (CCR9) and its specific ligand CC motif chemokine ligand 25 (CCL25) are interesting candidate genes for celiac disease. These genes are located in regions previously shown to be associated with or linked to celiac disease, but no investiga...
LINKED CONTENT
This article is linked to Paavola et al and Therrien & Leffler papers. To view these articles, visit https://doi.org/10.1111/apt.16534 and https://doi.org/10.1111/apt.16552
Rasvamaksatauti on nykyisin lapsuusiän yleisin maksasairaus, joka hoitamattomana voi edetä kirroosiin saakka. Sekä kliininen kokemus että tutkimusnäyttö viittaavat sairauden merkittävään lisääntymiseen. Lapsilla esiintyy harvoin oireita. Tavallisin löydös ylipainon ohella on plasman suurentunut alaniiniaminotransferaasi (ALAT) -pitoisuus, jonka yle...
Objectives: An observed variation in the risk of celiac disease, according to the season of birth, suggests that vitamin D may affect the development of the disease. The aim of this study was to investigate if vitamin D concentration is associated with the risk of celiac disease autoimmunity (CDA) in genetically at-risk children.
Study Design: Chil...
Background
Family screening has been advocated as a means to reduce the major underdiagnosis of coeliac disease. However, the precise risk of the disease in relatives and the impact of patient- and relative-related individual factors remain obscure.
Aims
To investigate the individual risk of coeliac disease among patients' relatives.
Methods
Alto...
Background
It is not known if genetic background, characteristics at diagnosis, physical and psychological well-being, and adherence to a gluten-free diet are comparable between patients with familial or sporadic celiac disease. These issues were investigated in a follow-up study.Methods
Altogether 1064 patients were analyzed for celiac disease-ass...
LINKED CONTENT
This article is linked to Størdal et al and Sundqvist et al papers. To view these articles, visit https://doi.org/10.1111/apt.16361 and https://doi.org/10.1111/apt.16348
Keliakiaan liittymättömässä gluteeniherkkyydessä gluteenin syöminen aiheuttaa erilaisia suolisto-tai muita oireita, joiden koetaan helpottuvan gluteenia välttämällä. Potilaiden itse diagnosoima gluteeni-herkkyys on yleistynyt nopeasti, mutta todellista esiintyvyyttä ei tunneta, koska tautispesifiset diagnosti-set testit puuttuvat. Kansainvälinen ko...
Background
Deep immune receptor sequencing, RepSeq, provides unprecedented opportunities for identifying and studying condition-associated T-cell clonotypes, represented by T-cell receptor (TCR) CDR3 sequences. However, due to the immense diversity of the immune repertoire, identification of condition relevant TCR CDR3s from total repertoires has m...
Objective
We examined parental diabetes monitoring behaviors in a cohort of children at increased genetic risk for type 1 diabetes. We hypothesized that being informed of a positive islet autoantibody (IA) would increase monitoring behaviors.
Methods
The Environmental Determinants of Diabetes in the Young (TEDDY) study follows 8676 children with h...
Anemia is a frequent finding in children with celiac disease but the detailed pathophysiological mechanisms in the intestine remain obscure. One possible explanation could be an abnormal expression of duodenal iron transport proteins. However, the results have so far been inconsistent. We investigated this issue by comparing immunohistochemical sta...
The phenotype of coeliac disease varies considerably for incompletely understood reasons. We investigated whether established coeliac disease susceptibility variants (SNPs) are individually or cumulatively associated with distinct phenotypes. We also tested whether a polygenic risk score (PRS) based on genome-wide associated (GWA) data could explai...
LINKED CONTENT
This article is linked to Fuchs et al and Paul et al papers. To view these articles, visit https://doi.org/10.1111/apt.15109 and https://doi.org/10.1111/apt.16133
The pathological mechanisms that lead to the onset and reactivation of celiac disease (CD) remain largely unknown. While gluten free diet (GFD) improves the intestinal damage and associated clinical symptoms in majority of cases, it falls short of providing full recovery. Additionally, late or misdiagnosis is also common as CD presents with a wide...
The clinical phenotype of celiac disease varies considerably among patients and the dosage of HLA-DQ2.5 alleles has been suggested to be a contributing factor. We investigated whether HLA-DQ2.5 allele dosage is associated with distinct clinical parameters at the time of diagnosis and with patients’ response to a gluten-free diet. The final cohort i...
Background:
Coeliac disease is an immune-mediated intestinal disease characterised by lifelong intolerance to dietary gluten in genetically predisposed individuals. Microbial factors including infections or bacterial microbiota have long been suspected to be involved in the aetiology, but the scientific literature on the topic is scattered and het...
Background
Introduction of nitisinone and newborn screening (NBS) have transformed the treatment of type 1 tyrosinemia, but the effects of these changes on the long-term outcomes remain obscure. Also, the predictors for later complications, the significance of drug levels and the normalization of laboratory and imaging findings are poorly known. We...
Non-biopsy diagnosis of celiac disease is possible in children with anti-transglutaminase 2 antibodies (TGA) > 10× the upper limit of normal (ULN) and positive anti-endomysial antibodies (EMA). Similar criteria have been suggested for adults, but evidence with different TGA assays is scarce. We compared the performance of four TGA tests in the diag...
Background:
Early detection of celiac disease could theoretically prevent most of the disease-associated complications, but long-term effects of this approach are unclear.
Aims:
To investigate features at diagnosis and adulthood health in celiac disease patients diagnosed in early childhood in 1965-2014.
Methods:
Medical data on 978 pediatric...
The often poorly orientated small-bowel mucosal biopsies taken for the diagnostics of celiac disease and other intestinal disorders are prone to misinterpretation. Furthermore, conventional histopathology has suboptimal sensitivity for early histopathological changes observed in short-term challenge studies. X-ray microtomography (micro-CT) is a pr...
Type 1 diabetes (T1D)—an autoimmune disease that destroys the pancreatic islets, resulting in insulin deficiency—often begins early in life when islet autoantibody appearance signals high risk1. However, clinical diabetes can follow in weeks or only after decades, and is very difficult to predict. Ketoacidosis at onset remains common2,3 and is most...
Background: Introduction of nitisinone and newborn screening (NBS) have transformed the treatment of type 1 tyrosinemia, but the effects of these changes on the long-term outcomes remain obscure. Also, the predictors for later complications, the significance of drug levels and the normalization of laboratory and imaging findings are poorly known. W...
Background: Introduction of nitisinone and newborn screening (NBS) have transformed the treatment of type 1 tyrosinemia, but the effects of these changes on the long-term outcomes remain obscure. Also, the predictors for later complications, the significance of drug levels and the normalization of laboratory and imaging findings are poorly known. W...
Serology for anti‐epidermal transglutaminase antibodies (Anti‐TG3 Abs) has attracted interest, being inexpensive and non‐invasive and could ideally replace skin biopsy for the diagnosis of Dermatitis Herpetiformis (DH)1. The current commercially available ELISA (Elisa Kit) for serum Anti‐TG3 Abs overall has a good specificity (84‐100%)2‐4 however,...
Variable endoscopic and histological findings of esophageal lining are often detected in celiac disease, with unknown significance. We investigated the frequency and significance of such abnormalities in children. Macroscopic esophageal findings as reported by endoscopist and histological results by pathologist were compared between 316 celiac dise...
Risk of celiac disease (CD) is increased in relatives of CD patients due to genetic and possible environmental factors. We recently reported increased seropositivity to anti-Saccharomyces cerevisiae (ASCA), Pseudomonas fluorescens-associated sequence (anti-I2) and Bacteroides caccae TonB-linked outer membrane protein (anti-OmpW) antibodies in CD. W...
The treatment of choice for dermatitis herpetiformis (DH), a cutaneous manifestation of coeliac disease, is a life-long gluten-free diet (GFD). In a GFD, wheat, rye and barley should be strictly avoided, but the role of oats is more controversial. This study aimed to investigate the safety and long-term quality of life and health effects of oat con...
Goals:
To test the accuracy of serology-based criteria for diagnosing celiac disease utilizing quantitative histomorphometry.
Background:
The revised European pediatric guidelines allow noninvasive celiac disease diagnosis for a subgroup of children. However, in some of the studies on this issue, the positive predictive value (PPV) of serology h...
Background
Type 1 tyrosinemia is a hereditary metabolic disease in which tyrosine metabolites damage the liver and kidneys. Nitisinone medication revolutionized the treatment, but the effects of the drug during human pregnancy are unknown.
Case report
A 17-year-old tyrosinemia patient became pregnant. Nitisinone was continued throughout pregnancy...
Dermatitis herpetiformis (DH), a cutaneous manifestation of coeliac disease, is characterized by transglutaminase (TG) 3-targeted dermal immunoglobulin A (IgA) deposits. The treatment for DH is the same as for coeliac disease, namely a life-long gluten-free diet. DH patients typically have gluten-dependent circulating autoantibodies targeting TG3 a...
Objectives:
Current pediatric guidelines allow non-invasive diagnosis of celiac disease in selected children. We investigated in a large cohort study whether the severity of villous atrophy at diagnosis is associated with clinical characteristics or long-term health outcomes, thus having a prognostic significance.
Methods:
Comprehensive medical...
Background
Follow-up of coeliac disease is recommended to prevent complications associated with unsuccessful treatment.
Objective
The objective of this article is to evaluate the implementation and significance of long-term follow-up.
Methods
Medical data were collected from 585 and follow-up questionnaires sent to 559 current adult coeliac disea...
Background and aims:
Intestinal diseases are regarded as a common cause of anemia, but the diagnostic outcomes of children with anemia undergoing endoscopic investigations are unclear. We investigated this issue in a large cohort of children.
Methods:
Indications for and findings of consecutive gastrointestinal endoscopies were collected. Clinic...
Background:
Celiac disease diagnostics begin by measuring autoantibodies, which may fail to identify seronegative patients. Duodenal lesion in the absence of antibodies is scarcely studied, especially in children.
Aims:
To investigate the prevalence and diagnostic outcomes of children with seronegative duodenal lesion in two countries with diffe...
Coeliac disease is an immune-mediated enteropathy against dietary gluten present in wheat, rye and barley and is one of the most common lifelong food-related disorders worldwide. Coeliac disease is also considered to be a systemic disorder characterized by a variable combination of gluten-related signs and symptoms and disease-specific antibodies i...
Objective
Higher gluten intake, frequent gastrointestinal infections and adenovirus, enterovirus, rotavirus and reovirus have been proposed as environmental triggers for coeliac disease. However, it is not known whether an interaction exists between the ingested gluten amount and viral exposures in the development of coeliac disease. This study inv...
Objectives:
The ESPGHAN 2012 coeliac disease (CD) diagnostic guidelines aimed to guide physicians in accurately diagnosing CD and permit omission of duodenal biopsies in selected cases. Here, an updated and expanded evidence-based guideline is presented.
Methods:
Literature databases and other sources of information were searched for studies tha...
Importance
High gluten intake during childhood may confer risk of celiac disease.
Objectives
To investigate if the amount of gluten intake is associated with celiac disease autoimmunity and celiac disease in genetically at-risk children.
Design, Setting, and Participants
The participants in The Environmental Determinants of Diabetes in the Young...
Celiac disease is one of the most common food-related chronic disorders in children. Unfortunately, this multifaceted disease is challenging to recognize and remains markedly underdiagnosed. Screening of either known at-risk groups or even the whole population could increase the suboptimal diagnostic yield substantially. Many recent guidelines reco...
Probiotics are linked to positive regulatory effects on the immune system. The aim of the study was to examine the association between the exposure of probiotics via dietary supplements or via infant formula by the age of 1 year and the development of celiac disease autoimmunity (CDA) and celiac disease among a cohort of 6520 genetically susceptibl...
The prevalence and associated factors of daily life restrictions due to a gluten-free diet in adult celiac disease patients diagnosed in childhood are poorly known. We investigated these issues by collecting the medical data of 955 pediatric patients and sending questionnaires evaluating various health outcomes to the 559 patients who had reached a...
Objectives: Type 1 tyrosinemia is caused by an inherited lack of enzyme in tyrosine metabolism, leading to accumulation of toxic metabolites. Introduction of nitisinone medication in the 1990s revolutionized the treatment and increasing number of drug-treated patients are now reaching childbearing age. Nitisinone prevents the production of toxic me...
Aim
As imaging is used for various reasons in children with acute gastrointestinal complaints, we evaluated the indications and diagnostic yield of abdominal imaging, particularly ultrasound at emergency department (ED).
Methods
Indications and imaging reports of consecutive children who had undergone abdominal imaging in general, surgical and pae...
Linked Content
This article is linked to Fuchs et al and Scicluna and Ellul papers. To view these articles, visit https://doi.org/10.1111/apt.15109 and https://doi.org/10.1111/apt.15202.
The factors determining the presentation of celiac disease are unclear. We investigated the phenotypic concordance and the distribution of human leukocyte antigen (HLA) risk haplotypes in affected siblings. One hundred sibling pairs were included. Clinical and histological parameters and HLA haplotypes were compared between the first diagnosed inde...
Background
The revised paediatric criteria for coeliac disease allow omission of duodenal biopsies in symptomatic children who have specific serology and coeliac disease‐associated genetics. It remains unclear whether this approach is also applicable for adults with various clinical presentations.
Aim
To evaluate the accuracy of serology‐based cri...
Motivation
Deep immune receptor sequencing, Repseq, provides unprecedented opportunities to identify condition-associated T-cell clones, represented by T-cell receptor (TCR) CDR3 sequences. TCR profiling has potential value for increasing immunopathological understanding of various diseases, and holds considerable clinical relevance. However, due t...
Background
In coeliac disease, ingestion of gluten induces the production of transglutaminase 2 (TG2)-targeted autoantibodies by TG2-specific plasma cells present at high frequency in the small intestinal mucosa in untreated disease. During treatment with a gluten-free diet (GFD), the number of these cells decreases considerably. It has not been pr...
Background and Aims
In nonresponsive celiac disease (NRCD), the symptoms and duodenal damage persist despite a gluten-free diet. Celiac disease patients with persistent symptoms are found to have a dysbiotic microbiota. We thus hypothesized that increased seroreactivity to the serum gluten-sensitive microbial antibodies Saccharomyces cerevisiae (AS...
Population-based screening studies have shown celiac disease to be one of the most common chronic gastrointestinal diseases. Nevertheless, because of the diverse clinical presentation, the great majority of patients remain unrecognized. Particularly difficult to identify are the multifaceted extraintestinal symptoms that may appear at variable ages...
Aim
Coeliac disease is a common but markedly under‐diagnosed condition, which may lead to serious long‐term complications if untreated. Both the diagnostic yield and true incidence have significantly increased during the last few decades and it is now one of the most common chronic gastrointestinal conditions in children. The aim of this review was...
Background:
The diagnostic yield of coeliac disease could be improved by screening in at-risk groups, but long-term benefits of this approach are obscure.
Objective:
To investigate health, quality of life and dietary adherence in adult coeliac patients diagnosed in childhood by screening.
Methods:
After thorough evaluation of medical history,...
Objectives and Study: While type 1 tyrosinemia is globally rare, it has enriched in certain
geographical areas for example in Northern Europe and Canada. Liver transplantation usedto be the only cure, but discovery of nitisinone medication has revolutionized the treatment. In addition, recently launched newborn screening programs should reduce the...
Introduction:
Guidelines recommend regular follow-up in coeliac disease, but effect of this on long-term outcomes remains unclear.
Aims:
To evaluate predictors and significance of long-term follow-up.
Methods:
677 previously diagnosed coeliac patients were recruited for a nationwide health survey. Medical data were gathered through interviews...
Milk powder and gluten are common components in Swedish infants' diets. Whereas large intakes of gluten early in life increases the risk of celiac disease in genetically at-risk Swedish children, no study has yet evaluated if intake of milk powder by 2 years of age is associated with celiac disease. A 1-to-3 nested case-control study, comprised of...
Aim
This study investigated the prevalence of extraintestinal manifestations (EIM) in paediatric celiac disease and their associations with other disease features.
Methods
Researchers at the University of Tampere, Finland, compared EIM in 511 children diagnosed with celiac disease from 2003‐2014 and 180 diagnosed with functional gastrointestinal d...
Citations
... In a study reported in this issue of the journal, Aitokari et al. 22 compared age-specific pediatric (6 to 17-year-old) 95th percentiles of ALT values data from the general Finnish prospective Physical Activity and Nutrition in Children 23 study (i.e., 24-29 U/L for Finnish girls and 29-32 U/L for boys) with those of 675 children with OB/OW selected for not having hepatitis B/C or drug toxicity possibly affecting the liver. The new ageand gender-related Finnish cutoffs applied to this cohort resulted in a prevalence of an approximately 1.5-fold mean increase of serum ALT values and MASLD prevalence in all ages and sexes in respect of fixed NHANES cutoffs. ...
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... Other than reasonable agreement in the diagnostic threshold region near the ULN, an important insight revealed that perhaps the older tTG-IgA AB (recombinant) version should lower the ULN from a value of four to three. Supporting this premise is a very recent meta-analysis of a large population of diagnosed CeD patients, which reported that a significant proportion who were originally diagnosed in the upper normal tTG-IgA range were subsequently diagnosed to have CeD [33]. The threshold for positivity for patients with a normal gluten-containing diet may not provide reliable results compared to the context of a gluten challenge where the degree of and direction of change in CeD serology may be more sensitive. ...
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... 24 Again, using 2 separate cohorts of children at risk of developing CeD, recent work has linked increased intake of a "western diet" at 2 years of age with an increased risk of CeD. 12,25 Although another separate prospective study found that high intake of vegetables, vegetable oils, pasta, and grains, and low intake of refined cereal and sweet beverages at 1 year were associated with lower odds of CeD autoimmunity. 26 Together, these studies suggest that although the timing of gluten introduction to infants may not influence childhood CeD development, the amount of gluten may be an important disease modifier. ...
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... This can have a specific and significant impact on future mechanistic and clinical protocols in several disorders of the upper-GI tract. The role of diet as trigger and treatment is best established for celiac disease, a malabsorptive condition triggered by an immune response to wheat protein [10]. ...
... 24 Second, while both Aitokari et al. 22 and SAFETY 12 studies applied ALT 95th percentiles, other studies have used the 97th or 97.5th percentiles, possibly resulting in up to 3-15 U/L ALT's higher cutoffs. 25 Third, ALT's modest accuracy has been documented by the possible occurrence of NAFLD in patients with normal transaminases and normal-weight patients with NAFLD. 26,27 Finally, similarly, other attempts to assess ALT thresholds made in other specific populations as a proxy for better assessing the NAFLD risk/diagnosis in Canada, 24 and several European (e.g., Netherlands, 28 Sweden, 29 Europe 30 ), and Asian countries (e.g., ...
... Thirdly, a number of patients, suspected to suffer from CD, have initiated a GFD before diagnosis has been set. Therefore, gluten-containing foods have to be reintroduced into the diet for a sufficient duration to reproduce serological abnormalities and characteristic intestinal damage [8]. This approach, however, implies the disadvantage that the physician cannot recognize in case of negative diagnostic findings, whether the patient has ingested sufficient amounts of gluten. ...
... Nevertheless, several studies have highlighted several factors that are positively associated with adherence of pediatric CD patients to a GFD: having a first-degree relative with celiac disease [13], the presence of gastrointestinal symptoms [14], good parental knowledge about CD [2], and being a member of a CD patient society [2]. ...
... Presence of autoimmune disease and anaemia in 2000 predicted later coeliac disease in a crude analysis, but the latter disappeared after adjusting for concurrent TGA positivity. While the association of coeliac disease with other autoimmunity is well established, [40][41][42] there is a scarcity of long-term follow-up data on the actual risk. ...
... Type 1 diabetes susceptibility genes have previously been found to interact with Caesarean section (IFIH1 [4]) or to be associated with increased progression to stage 3 type 1 diabetes (TNFAIP3, CTSH, MIR2681HG [8]). After stratification for Caesarean section, no differences in progression to stage 3 type 1 diabetes were observed for the IFIH1 (rs1990760) genotypes (ESM Fig. 3a). ...
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... mmol/l (100-125 mg/dl) • 120 min OGTT 7.8-11.0 mmol/l mg/dl) • OGTT values ≥11.1 mmol/l (≥200 mg/dl) at 30, 60 and 90 min • HbA 1c 39-47 mmol/mol (5.7-6.4%) or longitudinal ≥10% increase in HbA 1c [66,67] from the first measurement with stage 2 T1D • CGM values >7. 8 Content courtesy of Springer Nature, terms of use apply. Rights reserved. ...
![[object Object]](https://i1.rgstatic.net/ii/profile.image/1039771849740291-1624912335429_Q64/Kendra-Vehik.jpg)
